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Face-to-Face Diagnosis vs Telediagnosis of Pigmented Skin Tumors
A Teledermoscopic Study
Domenico Piccolo, MD;
Josef Smolle, MD;
Ingrid H. Wolf, MD;
Ketty Peris, MD;
Ranier Hofmann-Wellenhof, MD;
Giordana Dell'Eva, PhD;
Marco Burroni, PhD;
Sergio Chimenti, MD;
Helmut Kerl, MD;
H. Peter Soyer, MD
Arch Dermatol. 1999;135:1467-1471.
Background Teledermoscopy uses telecommunication technologies to transfer images of pigmented skin lesions, including clinical and anamnestic data, via e-mail to specialized centers for teleconsultation.
Design Sixty-six pigmented skin lesions examined on a face-to-face basis in a skin lesion clinic in L'Aquila, Italy, were sent via e-mail on a standard-resolution color monitor for consultation at a university dermatology department in Graz, Austria.
Intervention Digital photographs of the clinical and dermoscopic images of all pigmented tumors were taken with a stereomicroscope connected to a high-resolution video camera in Truevision advanced graphic array (Targa) format file and converted successively into a Joint Photographic Expert Group (JPEG) format file. All lesions were excised surgically and diagnosed histopathologically.
Main Outcome Measure Diagnostic concordance between face-to-face diagnosis and telediagnosis.
Results The diagnostic concordance was 60 (91%) of 66 cases. The number of correct telediagnoses was lower, but the difference was not statistically significant (Wilcoxon test, P = .10). The accuracy of the telediagnoses was not related to the quality of the images, but highly depended on the level of diagnostic difficulty of a given pigmented skin tumor (Spearman correlation, P = .01).
Conclusion Teleconsultation of clinical and dermoscopic images of skin tumors via e-mail provides a similar degree of diagnostic accuracy as face-to-face diagnosis.
From the Departments of Dermatology, University of L'Aquila, L'Aquila, Italy (Drs Piccolo, Peris, and Chimenti), and University of Graz, Graz, Austria (Drs Smolle, Wolf, Hofmann-Wellenhof, Kerl, and Soyer); and the Biomedical Engineering Group, Siena, Italy (Drs Dell'Eva and Burroni).
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